Varicose Veins – Risks, Causes, and Symptoms

Varicose veins are enlarged, swollen, or twisted veins that occur when veins get oversaturated with blood. Blue or dark purple in colour, these veins are seen almost always on the legs and feet. This is a common condition that affects almost 1 in 3 adults worldwide, and are for many a family trait. Women are more likely to develop varicose veins, with them being at twice as much risk to develop this condition.

These superficial twisted and swollen veins can be also be accompanied by patches of flooded capillaries called spider veins. Although they can seem unattractive, they are usually harmless. However, when inflamed, they can be painful and be tender to touch. In such cases, these veins can hinder the circulation of blood in the lower extremities, causing itchiness, swollen ankles, and aches in the affected leg.

Besides developing superficially, on rare occasions, interior leg veins can also become varicose. The deeper venous network of the legs is usually not visible. Such varicose veins can cause aches and inflammation throughout the limb and even blood clots.

What causes varicose veins?

Circulation of oxygen-rich blood throughout the body requires arteries and veins working together to pump blood from the heart and back to it. To push back blood to the heart, veins rely on the surrounding thick layers of elastic tissue and muscles. Cup-like valves in veins allow a one-way flow of blood to prevent backflow. For proper circulation, it is important the veins in the extremities function properly.

If these veins become varicose, one-way valves can get damaged or become faulty, allowing the blood to pool in the veins. This makes it hard for the supporting muscles to push the blood (especially in the legs) against gravity. As less blood flows from one valve to the next back to the heart, more of it continues to pool in the veins. This incremental pooling increases congestion and pressure in the veins, making them twist and bulge. Because of these tendencies, varicose veins tend to develop mostly in the veins farthest from the heart – in the legs, where the muscle support for the veins is much less than that for interior veins.

What are the risk factors?

Physical conditions that put excessive pressure on the abdominal area and legs can cause varicose veins. Potential factors that can cause varicose veins include:

• Pregnancy
• Menopause
• Obesity
• Sedentary lifestyle: Weak muscles offer poor support for pumping blood through the veins. A lifestyle that results in poor muscle tone and condition increases the risk of varicose veins.
• Tumours
• Standing for prolonged durations: People whose occupations require them to stand for long periods are at a greater risk of varicose veins.
• Chronic constipation
• Leg injury: Damaged valves from a prior injury can cause varicosity.
• Genetics: If there is a family history of varicosity, the risk of your suffering from varicose veins increases.
• Age: The risk of varicose veins also increases with age. Muscles weaken, daily activity reduces, arterial walls become stiffer and less elastic, and vein valves suffer more wear and tear with time. All these contribute to increasing the risk of varicosity.
• Venous insufficiency: This can occur when nutrients, blood, and waste is not exchanged between the skin and blood properly because of weak blood flow.
• Tobacco consumption
• Deep vein thrombosis (DVT): A blood clot forming in a deep vein can block blood flow and cause varicosity. This medical condition is called DVT. These clots usually develop in the lower leg and thigh.

Pregnancy and Varicose veins

Pregnant people are at a greater risk of developing varicose veins due to various factors, making them more likely to develop varicose veins than at any other point in their lives. These include:

• Additional pressure is put on the circulatory system with pregnancy. Pregnant people have a lot more blood in their bodies, and this added burden of pumping more blood from the lower limbs adds to the risk of varicosity.
• Changes in hormone levels can also cause the relaxation of the walls of blood vessels.
• As the pregnancy progresses, the pressure on the pelvic region increases with the growing womb. While varicose veins resulting from advanced pregnancy usually dissipate after the pregnancy, this is not always the case. Sometimes, even though varicosity improves, visible markers of the condition remain.

What are the symptoms of varicose veins?

• A sensation of heaviness in the legs, especially after physical exertion or during sleep.
• Swelling in ankles
• Longer bleeding than usual in the area (caused by an injury)
• Pain or ache in legs
• Spider veins or telangiectasia
• Hardening or tapering of the skin above the ankles with inflammation of fat under the skin.
• Cramping in legs upon standing suddenly
• Redness, dryness, and itching in the affected area. This condition is called venous eczema.
• Shiny discolouration of the skin near the varicose veins
• Scar-like irregular, whitish patches near the ankles.
• Restless leg syndrome: A nearly uncontrollable urge to move the legs due to the feeling of some discomfort, usually in the evenings.

Are they dangerous?

Varicose veins can appear quite sickly – swollen, twisted, or bulging with a dark purple or blue colour. Though these veins on the legs may be unpleasant to look at, they are seldom painful by themselves.

However, they can sometimes be dangerous if left untreated:

• Untreated varicosity can lead to the formation of blood clots in the interior or deep veins (deep vein thrombosis).
• Varicose veins can also burst, causing a medical emergency.
• Varicosity in the testicular veins can lead to infertility in men.

When should I consult my doctor about varicose veins?

If you are concerned about varicose veins, how they look, or if they are uncomfortable, a consultation with your healthcare provider will be helpful.

You should seek a professional consultation if you see that the veins or your skin are:

• Swollen and painful
• Inflamed, red, and warm to touch
• Bleeding
• Discoloured

For more information about varicose veins, consult the best vascular surgeons in Bangalore at the Department of Vascular and Endovascular Surgery in Sagar Hospitals.

What are the Common Urinary Problems in the Elderly?

As much as many diseases are connected to our lifestyles, there are others that come with age, as our bodies change. A few of them are bladder-related problems. As you get older, your bladder changes. The bladder tissue, for instance, can toughen and become less elastic. This loss of elasticity can mean a lowered capacity to hold as much urine in your bladder as earlier and, consequently, more trips to the bathroom. On the other hand, a weak pelvic floor and bladder walls may make it harder for the bladder to be emptied fully and cause urine to leak.

Common bladder problems

• Urinary tract infection (UTI):
• UTIs are very common infections that can occur in your body. More than 50% of women suffer from a UTI at least once in their lifetime and this infection can occur anywhere in your urinary system. The chances of a UTI increase the longer urine stays in the bladder. This occurs more with age as bladder muscles weaken, making it harder for the bladder to be emptied completely.
• The various kinds of UTIs include:
• - Bladder infection: Bacterial infection in the bladder is the most common kind of UTI. It is most commonly caused by E.Coli, a bacteria found in the gastrointestinal tract. A bladder infection can cause a patient a sudden urge to urinate.
• - Urethra infection: A less common infection, urethra infections occur when bacteria from the gastrointestinal tract enter the urethra. This kind of UTI is more common in women, as their vagina is closer to their anus.
• - Kidney infection:
• - Bladder infections can spread to the kidneys, causing serious problems. Kidney infections that occur frequently or are not eradicated in time can impair kidney function permanently.

• Lower intestinal tract symptoms (LUTS):
• LUTS broadly represent a group of symptoms caused by issues with the urethra, bladder, or pelvic floor muscles.
• Various kinds of LUTS include:
• - Overactive bladder:With age, it becomes harder for older people to store urine in the bladder because of weaker bladder muscles. This can cause frequent urination or even urinary incontinence.
• - Prostate Enlargement:The prostate is situated near the neck of the bladder. When it gets enlarged it can cause problems with coordination between the urethra and bladder muscles, causing problems with urination.
• - Problems with water balance:With ageing, the kidneys begin to lose the capacity to reduce the amount of urine. This can result in increased urination, especially at night. It is normal for the elderly above the age of 65 to urinate more frequently at night.

Other causes of LUTS include urinary infections, bladder stones, diabetes mellitus, neurological conditions, and bladder and prostate cancer.

Symptoms of a urinary problem

Bladders seldom have consistent behaviour. But it is wise to keep an eye out for various symptoms that may signal a urinary problem.

• You are unable to hold urine or frequently leak urine. This is known as urinary incontinence.
• You experience a sudden and strong urge to urinate.
• There is a need to urinate more than 8 times a day.
• You wake up several times in the night to urinate.
• Your urine is cloudy or bloody.
• Only small amounts of urine pass after experiencing a strong urge to urinate.
• There is burning or pain before, during, or after urinating.
• There is trouble urinating or the stream of urine is weak. This can also show as an inability to empty your bladder.

If you experience any of these symptoms, talk to your urologist or your primary doctor.

What tests can diagnose urinary problems?

• Blood sugar is tested to diagnose diabetes mellitus.
• Rectal examination/ prostate examination can detect an enlarged prostate. Your doctor may prescribe further blood tests to rule out prostate cancer.
• Ultrasound of the Kidneys, Ureter and Bladder (KUB) is used to evaluate the urinary tract and check the size of the prostate, residual urine volume, state of the kidneys, and other urinary stone issues.
• Serum prostate-specific antigen (PSA) can be used to measure PSA levels to detect initial markers of prostate cancer. Other PSA-related tests are, however, required to confirm this diagnosis.

Shoulder Arthroscopy – What Should You Know?

The shoulder is one of the most complex joints in your body and is capable of more motion than any other joint. The shoulder joint comprises three bones: the shoulder blade, the upper arm bone, and the collarbone. Injury/ disease/ age-related wear and tear to the bones or tissues of the shoulder can cause pain, inflammation, reduced mobility, and instability.

Shoulder arthroscopy is conducted using a small instrument known as the arthroscope. The surgeon makes a small incision in the shoulder joint to insert the arthroscope into the surgical site. This instrument has a light system and camera that is used to project images of the inside of the joint onto a screen for a clear view. The arthroscope also has small surgical instruments within it that the surgeon can use to conduct certain medical procedures.

When is a shoulder arthroscopy recommended?

Your doctor or orthopaedic surgeon may recommend you a procedure called shoulder arthroscopy if you are suffering from shoulder pain that is not responding to traditional non-surgical treatments. Nonsurgical treatments include pain medication, physical therapy, rest, and injections.

Shoulder arthroscopy is used to treat injuries and diseases related to muscles, ligaments, tendons, cartilage, and bones of the shoulder joint.

These conditions include:

• Shoulder instability
• Damaged ligaments or cartilage
• Inflamed tissue or loose cartilage
• Tear in the rotator cuff
• Rupture in the biceps
• Arthritis of the collarbone
• Bony projections or bone spurs
• Stiffness in the shoulder joint

Procedures for repairing fractures, releasing nerves, and excising cysts can be performed on rare occasions with arthroscopy as well.

What are the risks associated with a shoulder arthroscopy?

Though shoulder arthroscopy is considered a low-risk alternative to more invasive procedures, there still are risks associated with the surgery.

The risks of shoulder arthroscopy are:

• Weakness in the shoulder
• Shoulder stiffness
• Delayed or failure of the repair to heal
• Nerve injury
• Injury to blood vessels
• Damage to shoulder cartilage

What are the advantages of this procedure?

The major benefit of shoulder arthroscopy over open surgery is the lowered risk of infection and a shorter time for recovery.

Shoulder arthroscopy offers benefits over open surgery such as:

• Fewer complications
• Less joint stiffness and pain
• Faster recovery
• Fewer stitches

How do you prepare for the procedure?

• You will have to inform the doctor of all the medication and supplements you may be taking before the procedure to avoid any adverse interactions. This holds true especially for common OTC medications such as aspirin and ibuprofen.

What happens during a shoulder arthroscopy?

• First, your surgeon will put you under general or reginal anaesthesia before performing the procedure. While regional anaesthesia will numb the arm or upper limb, general anaesthesia will put you to sleep.
• During the procedure, your doctor will decide to position you on your side (known as the Lateral Decubitus Position) or have you reclining in a semi-seated position (known as the Beach Chair Position).
• Sterile fluid will be injected into the shoulder joint to expand it to offer the surgeon a clearer view.
• Small incisions will be made to insert the arthroscopic camera. Your surgeon will be able to see clear images of the shoulder joint on his screen and diagnose the injured area.
• Surgical instruments will be introduced into the incision and the surgeon will repair or remove the damage to the joint.
• After the repairs are made, the sterile liquid will be drained from the shoulder joint and the incision(s) will be closed with stitches or sterile bandages.

Recovering from an arthroscopy

Your recovery will involve spending time at the hospital to rule out serious complications followed by recuperation at home.

Postoperative care

After the surgery, you will be under observation for a few hours before being discharged home. Medical personnel will monitor your responsiveness and provide medication to manage pain, if required.

Recuperating at home:

Though shoulder arthroscopy is less invasive than open surgery, it may still take you weeks to a few months for your shoulder joint to completely recover from the procedure and repairs.

• Expect pain and discomfort for several weeks after the procedure. A longer and extensive surgery will entail a longer recovery period as well. Rest and ice may help relieve some pain and swelling.
• You may be prescribed pain medication by your doctor to help control the pain. These medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and local anaesthetics, will help you be more comfortable and help your body recover from the surgery.
• Your shoulder will, in most likeliness, be immobilised with a sling or a special immobiliser to protect your shoulder and provide stability.

Rehabilitation

Rehabilitation plays an important role in getting a patient back to daily activities with normal motion and strength. Your orthopaedic surgeon will develop a rehabilitation plan for you based on the procedures you have to undergo. This may involve seeing a physical therapist for a specialised exercise regimen to recover from complicated surgical repair. A strong effort with the rehabilitative plan will improve your success for your surgery.

A shoulder arthroscopic procedure involves fewer complications, a faster recovery, and less pain and stiffness than open surgery. Though the procedure involves some risk, as all surgical procedures do, an arthroscopy is a procedure that lowers risk due to its less invasive nature. The recovery time of an arthroscopic procedure depends on the nature of the surgery conducted and may still be a few weeks long. Though recovery may seem like a slow process, following your surgeon’s prescribed steps and rehabilitation plan is vital for the successful outcome of your surgery. Learn more about shoulder arthroscopy from the orthopaedic surgeons in Sagar Hospitals, the best orthopaedic hospital in Bangalore.

What you should know about Knee Arthroscopy

Knee pain and discomfort that require you to visit an orthopaedic doctor can be from an injury, overuse of the knee joints, weakness, or ageing. Knee arthroscopy is a relatively less invasive surgical procedure to diagnose as well as treat knee joint problems. The procedure involves the orthopaedic surgeon making a small incision in your knee to insert a small camera called an arthroscope to inspect the inside of your joint. The orthopaedic surgeon is then able to investigate the cause of the painful symptoms and, if required, take corrective steps with instruments within the arthroscope.

Knee arthroscopy is useful in diagnosing various issues, including:

• Inflamed joint linings
• Persistent stiffness and pain in joints
• Damaged or torn cartilage
• Build-up of fluid that must be drained
• Floating bone or cartilage fragments

Benefits of knee arthroscopy

Compared with other forms of open orthopaedic surgery, knee arthroscopy is less invasive. The procedure allows the doctor to investigate and diagnose problems using a small instrument and without making a big incision. In fact, in most cases, the arthroscopy is more than sufficient to solve a host of problems.

Knee arthroscopy can be the preferred and combined investigative and treatment procedure because of benefits such as:

• Faster healing or recovery time
• Less tissue damage as compared to open surgery
• Fewer stitches
• A lower risk of infection with a smaller incision
• Less post-procedure pain

What are the risks?

Knee arthroscopy is considered a low-risk procedure and serious complications from it are uncommon. However, as is the case with any surgery, there are some risks.

There are risks that exist with any surgical procedure that include:

• An increased risk of infection and bleeding during or after the procedure.
• Complications with anaesthesia. Some people may face allergic reactions or breathing difficulties.

There are risks that are particular toknee arthroscopy surgery:

• Tissue or nerve damage: The movement and placement of arthroscopic surgical instruments within the joint can cause damage to the joint structure. There can be injury or damage to the ligaments, cartilage, blood vessels, meniscus, or nerves of the knee.
• Infection inside the knee joint
• Bleeding in the joints
• Chronic stiffness in the knee joint
• Blood clots: The risk of blood clots in the legs increases with lengthier procedures than can extend beyond an hour.

These risks are fairly uncommon and most people make an uncomplicated recovery.

How to prepare for the procedure

The preparation plan that your orthopaedic surgeon will make for you will be specific to your condition and the problem that your doctor will be diagnosing and repairing in your joints. Your doctor may also have you prepare with gentle exercises to make the procedure easier for you.

A few basic precautions to keep in mind before your procedure are:

• Fast before your surgery: Depending on the kind of anaesthesia that will be administered to you during the procedure, you may be required to stop eating solid foods 8-12 hours before the arthroscopy.
• Avoid certain dietary supplements and medication: Your doctor may want you to avoid taking medication or dietary supplements (such as fish oil) that can increase the risk of blood thinning and excessive bleeding.
• Wear comfortable, loose clothing. Choose clothing that you can easily dress in after the procedure.
• Arrange for help or an attendant for the day: You will not be allowed to drive by yourself after the procedure, so it is advisable to arrange for someone to pick you up. Also, if you live by yourself, ask a friend or family member to help you through the rest of the day.

Recovery after the procedure

Most knee arthroscopy procedures do not take longer than one hour. After that, the patient is kept under observation for a few hours before being sent home.

Your post-procedure care after the arthroscopy may include the following:

• R.I.C.E: Rest, ice, compression, and elevation is the basic care that will be advised by your doctor after the procedure for a few days, at least, to minimise the swelling and pain. You should use an ice pack on your knee and keep the site of the incision under dressing as advised by your doctor.
• Medication and other instructions: In addition to keeping your knee elevated and on ice, your dressing will have to be changed periodically. Your orthopaedic surgeon will provide you with precise instructions regarding follow-up appointments and medication to be taken to relieve inflammation and pain.
• Protection: You may be required to use a sling or crutches to protect your knee and avoid stressing the joint after your procedure.
• Physical therapy and exercise: You may be recommended a physical therapist to see until you are able to gain full function of your knee(s). The exercise regimen that your doctor will have you follow at home is an important part of your post-procedure care. Physical rehabilitation and exercises will help you strengthen your muscles and help restore the full range of motion of your knee joint.

Of the many open surgical procedures that are available for investigating and repairing joint problems, knee arthroscopy is one of the intrusive and complicated. While there are certain risks that follow any surgical procedure, the minimal nature of a knee arthroscopy means that most patients make a simple recovery and do not undergo serious complications during the procedure as well.

The severity of the knee problem directly impacts the time it takes to recover fully and the long-term outcome of the treatment as well. However, following the recovery plan of your orthopaedic surgeon, which includes exercise/ physical therapy and proper self-care minimises post-procedure issues and maximises recovery. Learn more about knee arthroscopy from the orthopaedic surgeons in Sagar Hospitals, the best orthopaedic hospital in Bangalore.

Thoracic Back Pain: what it is, identifying, preventing, and treating it

Pain in the upper and lower back, in the region known as the thoracic spine, is almost as common an ailment as lower back pain. The thoracic spine is the region below the neck and above the ribcage with 12 backbones with disks ranging from the T1 to T12 vertebrae.The thoracic spine or the middle and upper back, as it is also commonly called, plays an important role in the body: it anchors the rib cage to protect vital chest organs, such as the lungs and heart, and provides core stability to the body.

While the cervical or lower spine is built for mobility, the middle and upper back provides your body proper stability. There are various ways in which the muscles, ligaments, bones, and disks in the spine can injure nerves in the thoracic spine and cause back pain.

Symptoms of thoracic back pain

Symptoms of middle and upper back pain vary with the cause of the pain.

Some common symptoms of mid back pain because of daily activity or extra exertion during exercise or added activities during the weekend are:

• Dull pain
• Muscle ache
• Muscle stiffness or tightness
• Sharp or shooting pain
• Tenderness
• Burning sensation
• Headache

The above symptoms are typical of musculoskeletal strain, though they are known to occur with spinal injuries as well. However, if your thoracic pain is related to the nerves, bones, or disks of your thoracic spine, you will experience:

• Chest pain
• Numbness or tingling in your legs, chest, or arms
• Incontinence (loss of bowel control and/or bladder leakage)
• Pain down the legs
• Pain in the lower back
• Weakness in your legs or arms

What causes thoracic or middle back pain?

Some common causes of thoracic back pain related to daily lifestyle are:

• Overuse injuries: Also known as overuse injuries. This involves repeatedly using the thoracic part of the spine (for sport or work) for prolonged durations.
• Muscular irritation
• Lack of muscular strength
• Poor posture or sitting or standing in a slouched position for long durations.
• Prolonged sitting at a computer
• Using a backpack
• Obesity: There is a strong correlation between obesity and back pain. When body weight increases, so does the risk of back pain.

Middle or upper back pain can also be caused by some medical conditions. Though they are less common, thoracic back pain is likely to originate from them as well. They are:

• Trauma or injury from sports-related activities or whiplash from a car accident.
• Degenerative, metabolic, inflammatory, infective, or neoplastic conditions.
• From medical conditions such as osteoporosis, osteoarthritis, ankylosing spondylitis, or Scheuermann’s disease.

Preventing thoracic back pain

You can also work towards preventing everyday musculoskeletal strain that, over prolonged periods, causes thoracic back pain:

• Improve your posture:

  - Keep your shoulders back while standing

  - Avoid slouching while sitting or standing

  - Take breaks to stand and stretch if you sit for long durations of time through the day.

  - If you have a sedentary job that requires you to spend long hours at the desk, use an ergonomic chair that supports your back properly and adjust your computer monitor, mouse, keyboard, and mouse positioning to maintain good posture while working.

• Change your sleeping position: If you sleep on your back, you are more likely to cause misalignments in your spine and have upper back pain. It is suggested that you sleep on your side in the foetal position with a pillow between your knees.

Treatment for thoracic back pain

Though middle or upper back pain is painful and inconvenient, it is usually not a cause of serious concern. Many cases settle down on their own over time without any specific treatment. However, medical treatment and intervention should be sought immediately when the pain develops suddenly and severely, as in the cases of accidents and other injuries, and worsens progressively.

Treatment for thoracic back pain ranges from home remedies and everyday changes to surgeries. They include:

Home remedies:

Musculoskeletal strain can be treated at home with:

• Gentle stretches and rotations
• Application of ice to reduce inflammation and pain
• Heat compress to ease stiffness and improve mobility
• OTC pain medication such as paracetamol, ibuprofen.

Medical treatments:

• Prescription medication: Prescription anti-inflammatory or muscle relaxants may be given by your doctor to ease your middle or upper back pain. If depression is suspected to play a role, anti-depressants for long-term use may also be prescribed.
• Injections: Pain medication is injected at trigger points to provide relief and as means to pursue interventions such as exercise and physiotherapy.
• Physical therapy: Physical therapy and chiropractic care may be combined with medication or other interventions to ease and treat thoracic pain.
• Surgery: Surgery is rarely sought as means to provide relief for upper or middle back pain, but it can be chosen as the course of action if the problem is in the spine as in the case of vertebrae fracture, deformity, or a herniated disc.

The most common procedures for thoracic spine injury are:

• Spinal laminectomy/spinal decompression: Bony walls of the vertebrae may be removed by surgery to ease pressure on the nerves.
• Microdiscectomy: A minimally invasive procedure can be carried out to remove a spinal disc that is bulging and pressing on a nerve causing pain.
• Vertebroplasty or kyphoplasty: A glue-like bone cement can be injected to repair compression fractures caused by osteoporosis.

The outlook or prognosis for thoracic back pain depends on your general level of fitness, age, and the underlying cause. Most cases of upper or middle back pain resolve by themselves with some rest and without explicit medical intervention within a week or two. It is advisable to resume normal activities gradually to interfere with the recovery and avoid risking re-injury. Medication, physical therapy, and surgeries are often reliable and means to provide long-term relief from thoracic back pain. To learn more about pain in the thoracic spine, its prevention, and treatment, consult the orthopaedicsurgeons at the Sagar Brain & Spine Institute, the best orthopaedic hospital in Bangalore.

Responding to Sudden Cardiac Arrest

What is sudden cardiac arrest?

Sudden cardiac arrest (SCA) is a fast occurring and potentially life-threatening situation where the heart unexpectedly malfunctions and stops pumping blood. During an SCA, blood flow to the brain and other vital organs is disrupted. Unless medical attention is provided almost immediately, the risk of fatality increases rapidly.

A sudden cardiac arrest is different from a heart attack – an SCA is an electrical problem in the heart. A heart attack, on the other hand, occurs when there is a disruption of blood flow to some part of the heart muscle. The heart’s electrical system regulates the rhythm and rate of the heartbeat. Complications with this electrical system can cause irregularities in heartbeats known as arrhythmias. Arrhythmias can cause the heart to beat too slowly, too fast, or in irregular patterns. Such irregular heartbeats can result in the heart to stop pumping blood – these result in sudden cardiac arrest.

Patients suffering from cardiovascular conditions are at a higher risk of suffering a sudden cardiac arrest. However, SCA can occur in seemingly healthy people with no known history of heart disease or obvious risk factors to SCA.

What causes sudden cardiac arrest?

There are several risk factors that can cause irregularities in heart rhythms leading to a sudden cardiac arrest:

• Scarred or thickened heart muscle from coronary artery disease, prior heart attack, cardiomyopathy, viral infections, hereditary conditions, and other conditions that can damage and scar the heart tissue.
• Electrical abnormalities
• Poorly managed heart failure
• Coronary artery disease
• Blood vessel complications
• Use of recreational drugs
• Cardiomyopathy
• Family history and genetic conditions
• Smoking

Signs and symptoms of a sudden cardiac arrest

In order to respond to a sudden cardiac arrest, it is important that you are able to recognise the symptoms in this emergency situation. Watch carefully for signs such as:

• Lack of consciousness/ sudden loss of responsiveness: The person is not conscious, is collapsing, has collapsed, or isnot able to respond to your query when you ask if he or she is okay.
• Lack of pulse: During SCA, the heart stops beating and you may not be able to feel a pulse.
• No or abnormal breathing: The person may be breathing weakly or not at all.

How to respond during a sudden cardiac arrest (SCA)?

In the event that you observe the abovementioned symptoms in a person, you must act quickly and follow these steps immediately:

• 1. Check for responsiveness: Ask the person if they are all right and tap them to check for any signs of response. If the person is not moving, speaking, able to blink or react to your question in any way, and is unresponsive, follow through with the following steps.
• 2. Alert people around you and call for emergency medical services immediately. You can call 108, 102, or 112 for medical emergency help in India.
• 3. If the person is not breathing at all, perform cardiopulmonary resuscitation (CPR).
• 4. To administer CPR:

  - Clasp your hands together and place both your hands on the person’s breastbone.

  - Push hard and fast in the centre of the chest, making the chest move inward about an inch.

  - Push fast and at a controlled rate of 100 to 120 pushes a minute, and let the chest resume a normal position after each push. (Pushing to the beat of the song Staying Alive will get you approximately the 100-120 pushes.)

  - Continue performing CPR until medical help arrives or an AED is made available.

• 5. Use an automatic external defibrillator (AED) if available: A portable defibrillator comes with a mechanism for voice commands that gives you step-by-step instructions. AEDs are designed to provide audible commands to an untrained person at a time of cardiac emergency. The AED will diagnose the rhythm of the person’s heart before delivering a shock. The electric shock to restore normal heart rhythm will be delivered by the AED only if the person is suffering a cardiac arrest
• 6. In case there is no AED available and you are still waiting for emergency medical help to arrive, continue delivering CPR.

Most people who have suffered a sudden cardiac arrest survive if they receive help very quickly. The fatality rates of SCAs, however, are very high – 95%. Most fatalities occur because the person is alone, the people around did not know CPR or call emergency medical help, or if the emergency medical help does not arrive within the 10 minutes to avoid brain death. Though such statistics may seem discouraging, a healthy lifestyle with regular exercise, a balanced diet with low sugar and oil, and avoiding habits such as smoking and drinking go a long way in preventing heart disease and cutting risks of sudden cardiac arrests. For more information regarding your heart health and risks of cardiac disorders, book an appointment with the best cardiologists in Bangalore at the Sagar Heart and Vascular Institute.

The Dangerous Connection Between Diabetes and Heart Attacks: Are You At Risk?

The risk of heart disease increases with diabetes. Heart disease, also known as cardiovascular or coronary disease, can lead to a heart attack or stroke. A diabetes patient is twice as likely to develop heart disease and suffer a heart attack than someone who doesn’t have diabetes, and at a younger age as well. The longer you suffer from diabetes, the more your risks of heart complications increase.

Cardiovascular conditions affect your blood circulation too. This, in turn, make your diabetes complications worse. Thus begins a vicious cycle between heart disease and diabetes in which poor management of one condition worsens the other.

Diabetes and your heart

The health of your heart depends on the health of your veins and arteries. With diabetes and high blood sugar levels, the blood vessels and the nerves that control your heart can get damaged.

People with diabetes also face a greater danger of heart failure. With heart failure, the heart is unable to pump blood throughout the body effectively. This can lead to a build-up of fluids in the lungs and make breathing difficult.

Diabetes also increases the risk of other medical conditions that are detrimental to your heart health:

• High cholesterol or triglycerides: Low HDL cholesterol (“good” cholesterol) and high LDL (“bad” cholesterol) can lead to the hardening of arteries.
• High blood pressure: Your cardiovascular health suffers from having diabetes and high blood pressure with the increased force of blood through your arteries damaging artery walls.

Can you get “silent” heart attacks?

A common side effect of diabetes is neuropathy. Neuropathy is a kind of nerve damage that causes symptoms such as numbness, weakness in the extremities (hands and feet), and tingling sensations. This condition can also damage nerves that lead to your blood vessels and heart, making it difficult for you to gauge warning signals like pain and discomfort in your body.

In such a scenario, neuropathy can mask the pain and symptoms of a heart attack. A sort of mute button on the pain associated with a heart attack in the jaw, chest, and arm may seem fortuitous, but can be deadly if the patient is unable to identify the tell-tale symptoms of a heart attack and seek timely medical intervention.

Managing diabetes for taking care of your heart

The link between heart health and diabetes is not just down to elevated blood sugar levels; there are other conditions, such as high blood pressure and cholesterol, that go together in damaging blood vessels and complicating heart conditions.

The following tips and lifestyle changes can help you manage diabetes and your heart:

• Get regular exercise:
  Increased physical activity helps manage diabetes by improving your body’s sensitivity to insulin, the hormone that regulates blood sugar levels. Regular exercise also improves your heart health and reduces blood sugar levels. You should aim to get at least 150 minutes of moderate–intense exercise, such as brisk walking or light jogging, every week.

  
  

• Maintain a healthy body weight:
  For overweight diabetic patients, even modest weight loss of 5% - 7% of body weight can result in a considerable reduction in blood sugar and cholesterol.

  
  

• Follow a healthy, balanced diet:
  Avoid processed carbohydrates such as most fast foods, sweets and sugary drinks, and foods made from all-purpose flour. Reduce your alcohol and red meat consumption. Eat more vegetables and fruits, whole grains, and lean proteins.

  
  

• Reduce stress:
  Stress is closely linked to cortisol levels and blood pressure. Sustained stress is one the most common causes of high blood pressure and in turn can lead to unhealthy habits such as excessive drinking, eating, and smoking. To manage stress, seek help from friends and family, a mental health counsellor, try meditation, or get regular exercise.

  
  

• Manage your ABCs:
  

  • A: Get your HbA1C tests done every 2 – 3 months to measure your average blood sugar levels and try to keep them in the target range as recommended by your doctor.
  • B: Try to keep your blood pressure to levels below levels recommended by your doctor.
  • C: Manage your cholesterol levels.
  • s: Stop smoking (and avoid starting at all costs.)

People with diabetes are at a much higher risk of developing heart disease and heart attacks. Minimising risks of heart attacks that arise with diabetes isn’t just down to keeping your blood sugar in check – it is important to manage other contributing factors as well. In addition to the steps mentioned above, your doctor may also prescribe you medication to manage your blood sugar, cholesterol and triglyceride levels, and blood pressure to reduce the risk of a cardiovascular event.

For more detailed information about diabetes, heart conditions, and how to prevent emergencies like heart attacks, book an appointment with the best heart specialists in Bangalore at the Sagar Heart and Vascular Institute.

Insomnia In Teens Can Cause Heart Attacks

A vast number of adolescents are not getting sleep regularly. Though this may not come as a surprise to many parents, this trend can have a worrying impact on teenagers’ heart health. Health experts recommend more than 8 hours of sleep for adolescents aged 14 – 17 and more than 9 hours of sleep for those aged 11 – 13. Only about 50% of children get more than 7 hours of sleep, with older teens sleeping even less than their younger counterparts.

Why is sleep important?

As adults with many responsibilities, a good night’s sleep may seem like a luxury. However, sleep plays an integral role in the body’s recovery and optimal functioning. Good quality sleep is important for mental health, energy levels, blood pressure, metabolism, and – in particular – cardiovascular health.

Insomnia has high comorbidity with many cardiovascular diseases, including coronary heart disease, hypertension, incident cardiovascular disease, and heart failure. Additionally, regular poor sleep increases the risks of medical conditions such as diabetes and obesity and shortens life expectancy.

What are the risks for our teenage children?

Previous research has found links between insomnia in children and childhood obesity, and consequently, with higher blood pressure. As per a study published in the journal Pediatrics, researchers found that nearly 33% of adolescents slept for around 7 hours every night and that nearly half of them were fully asleep for less than 85% of the sleep time. All in all, the median sleep duration was a measly 7.35 hours every night for around 800 adolescents in the study ranging 11 – 17 years in age.

Researchers found that teenagers who did not get adequate sleep regularly had a higher body mass index (BMI) and belly fat, high blood pressure, abnormal cholesterol or blood lipids, and insulin resistance – a condition that increases the risk of diabetes.

All these comorbidities can drastically increase the risk of cardiovascular disease in teenage adolescents.

Why are our teenagers not sleeping properly?

Though medical conditions such as sleep apnoea affect sleep patterns directly in around 25% of men and around 10% of women, the primary cause of poor quality and inadequate sleep is mostly down to the lifestyle and poor sleeping habits.

Teenagers are caught between long school days, homework, projects, extra-curricular activities, with early school timings contributing to less sleep. With Generation Z brought up on mobile devices and social media, phone screens and computers take up a majority of the attention span of young and older teens. They ignore sleep, stay up late with the blue light from their devices keeping their brains awake, making it harder for them to fall asleep. In fact, the CEO of Netflix, Reed Hastings, once declared that the streaming service’s biggest competition is sleep – and that they’re winning.

How do we get teenagers to improve their sleeping habits?

When it comes to sleep and its dangers to our teenager’s heart health, we cannot just sit back and claim that “teens will be teens.” Their future health is at risk and this situation demands action.

The following tips can help your teenagers get the sleep they need:

• Develop discipline with devices and time on electronics:
  Make a rule that electronic screens and devices are powered down close to an hour before bedtime. Have your teen put his or her phone, tablet, laptop, and other mobile devices somewhere besides his or her room.

  Light-emitting devices and “blue light,” in particular, block the release of the sleep hormone melatonin and delay sleep. Also, just knowing that the device is at an arm’s length and new content and notifications is available in the app feed are adequate to keep your teen’s mind awake.

  
  

• Plan and prioritise sleep:
  If daily activities and school work make it impossible for your teen to get the necessary 8 hours of sleep, something has to give. Sit with your child, map out the day, and evaluate the way your teen spends his or her day. You will soon find the activities to prioritise to ensure good sleep for your teen.

  
  

• Go sugar- and caffeine-free after 5 PM:
  The caffeine and “sugar rush” from energy drinks, sugary sodas, and other sweets stay in your teen’s system for about 4 to 5 hours. Staving off these foods well before sleep time will help negate their ability to keep your child awake past his or her bedtime.

  
  

• Set sleep goals:
  Use reminders or alarms to remind your teenager of the time to start winding down and settle down to sleep. You can also encourage your teenager to make “sleep pacts” with his or her friends so that they all turn off their phones and say their goodnights at the same time.

  
  

• Maintain a regular schedule:
  Do not fall into the trap of “catching up on sleep” on weekends. Averaging out lost sleep over weekdays/ school nights with more sleep during weekends sounds like a tempting idea to maintain good cumulative sleep hours, but is a lost cause. Regular nightly sleep of good quality is what will most benefit your teenager in the long term.

Our teenagers’ future is the most important priority for us. That is why we warn them against developing bad habits and the risks of substances such as tobacco, drugs, and alcohol. This is precisely why we need to talk to them and help them understand the importance of sleep as well. Good sleep is necessary for your child’s development and good health and insomnia poses a serious threat to these. To learn more about how insomnia can affect your teen’s health or cardiovascular health, reach out to the best cardiologists in Bangalore at the Sagar Heart and Vascular Institute.

All you need to know about Delta Plus Variant

Since last 2 years, global healthcare is going through a challenging phase. What continues to keep the whole world on their toes is how to jointly deal with two situations; Pandemic and Panic. The Covid-19 virus continues to keep everyone guessing, but what still lingers in the mind of millions across the globe is, continued panic.

Just as all of us in India and overseas begin to heave a sigh of relief that the second wave is slowly coming to control, experts have found out another variant of the virus, this time, even more deadly and dangerous than the earlier ones – The Delta Plus.

Here, we talk about the Delta Plus Variant, the symptoms, risk factors and how to manage the situation.

What is the Delta Plus Variant?

Ever since it came into limelight for the first time in 2019, Coronavirus has been constantly changing forms and turning out into something more fearsome than its previous version. Labelled as, ‘a variant of concern’, this new mutant version of the Delta strain of Covid is known as Delta Plus.

The Delta Plus (B.1.617.2.1/ (AY.1) is seen as the next generation of SARS-COV-2. Research continues across the world to understand its severity and implications in greater depth. Studies conducted so far suggest that the Delta Plus variant is the result of the mutation in the spike protein of SARS-COV-2, which helps the virus enter the body and infect the human cells.

What are the symptoms of the Delta Plus Variant?

Top Virologists from across India and overseas have said that the symptoms of the Delta Plus variant are a combination of the Delta variant as well as its partner, Beta. They include, cough, diarrhoea, fever, headache, skin rash, discolouration of fingers and toes, chest pain, and shortness of breath.

Patients may present some other symptoms too like Stomach ache, nausea, vomiting and sudden loss of appetite.

Why is the Delta Variant a cause of concern?

Delta Plus has shown an increased ability to spread almost 60-70 times faster than its predecessor, the Delta variant. According to experts and studies conducted, this variant can easily attack the lungs and cause immense damage, leading to serious complications. According to one of the former senior most scientists associated with the Indian Council of Medical Research, two graded mutations which have occurred within the Delta variant have contributed to higher and faster transmission efficiency. This makes the Delta variant even more threatening than its predecessors.

Treatment and Support to manage the Delta Variant

Although medical experts are of the opinion that it is a bit early to predict the effectiveness of the existing vaccines on the new variant, they are of the firm opinion that Vaccination and safety measures such as wearing of face masks and maintaining physical distance are extremely critical to fighting the Delta Plus coronavirus variant, Detailed research continues on a war footing to find out more on how to arrest this rapidly surging variant.

The Bottom Line

At Sagar Hospitals, our interdisciplinary team of experts handle Delta plus variant infections in our patients, with utmost care and efficacy. In light of the continued variations observed in the behaviour of the Corona virus, it becomes increasingly difficult to predict when and how the virus will lose its stranglehold on human life. Till a concrete solution is arrived at, it becomes our independent responsibility to take care of ourselves and not ignore the slightest of the symptoms.

To know how you can be safe from the dangerous consequences of the Delta variant, meet our expert doctors at Sagar Hospitals for complete guidance and steps to be taken to stay safe and healthy.